Nonpharmaceutical Interventions for Pandemic Influenza, International Measures

Nicoll, A; Fukuda, Keiji; Horby, Peter; Monto, Arnold S.; Hayden, Frederick G.; Wylks, Clare E; Sanders, Lance

doi:10.3201/eid1201.051370

Cited by 268 publications

(104 citation statements)

References 33 publications

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“…In Bangladesh, handwashing with soap is uncommon [11], particularly after respiratory secretion contact [12], and thus, the risk of transmission via direct contact has the potential to be high [13,14]. The lack of data on the impact of handwashing promotion on household influenza transmission from low-income settings reflects a substantial gap in our understanding of how to minimize the effects of epidemic and pandemic influenza among the most vulnerable populations.…”

Section: Introductionmentioning

confidence: 99%

Impact of Intensive Handwashing Promotion on Secondary Household Influenza-Like Illness in Rural Bangladesh: Findings from a Randomized Controlled Trial

et al. 2015

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RationaleThere is little evidence for the efficacy of handwashing for prevention of influenza transmission in resource-poor settings. We tested the impact of intensive handwashing promotion on household transmission of influenza-like illness and influenza in rural Bangladesh.MethodsIn 2009–10, we identified index case-patients with influenza-like illness (fever with cough or sore throat) who were the only symptomatic person in their household. Household compounds of index case-patients were randomized to control or intervention (soap and daily handwashing promotion). We conducted daily surveillance and collected oropharyngeal specimens. Secondary attack ratios (SAR) were calculated for influenza and ILI in each arm. Among controls, we investigated individual risk factors for ILI among household contacts of index case-patients.ResultsAmong 377 index case-patients, the mean number of days between fever onset and study enrollment was 2.1 (SD 1.7) among the 184 controls and 2.6 (SD 2.9) among 193 intervention case-patients. Influenza infection was confirmed in 20% of controls and 12% of intervention index case-patients. The SAR for influenza-like illness among household contacts was 9.5% among intervention (158/1661) and 7.7% among control households (115/1498) (SAR ratio 1.24, 95% CI 0.92–1.65). The SAR ratio for influenza was 2.40 (95% CI 0.68–8.47). In the control arm, susceptible contacts <2 years old (RRadj 5.51, 95% CI 3.43–8.85), those living with an index case-patient enrolled ≤24 hours after symptom onset (RRadj 1.91, 95% CI 1.18–3.10), and those who reported multiple daily interactions with the index case-patient (RRadj 1.94, 95% CI 1.71–3.26) were at increased risk of influenza-like illness.DiscussionHandwashing promotion initiated after illness onset in a household member did not protect against influenza-like illness or influenza. Behavior may not have changed rapidly enough to curb transmission between household members. A reactive approach to reduce household influenza transmission through handwashing promotion may be ineffective in the context of rural Bangladesh.Trial RegistrationClinicalTrials.gov NCT00880659

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Section: Introductionmentioning

confidence: 99%

Impact of Intensive Handwashing Promotion on Secondary Household Influenza-Like Illness in Rural Bangladesh: Findings from a Randomized Controlled Trial

et al. 2015

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“…This was true for both the indices of support as well as for the models for individual NPIs (only select data shown). While international planning organisations, such as WHO, do recommend that nation states accommodate their own population needs, policy recommendations often are uniform (World Health Organization Writing Group, 2006). Even accounting for variations in the population characteristics themselves, this research indicates that public support will likely vary widely between regions.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, NPI use remains a particularly valuable option for underdeveloped regions of the world, where a pharmaceutical response may be totally absent or extremely delayed (World Health Organization Writing Group, 2006). The study’s finding suggests that policy planning should account for some degree of local flexibility or decentralisation.…”

Section: Discussionmentioning

confidence: 99%

Predicting support for non‐pharmaceutical interventions during infectious outbreaks: a four region analysis

Pillemer

Blendon²,

Zaslavsky

et al. 2014

Disasters

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Non-pharmaceutical interventions (NPIs) are an important public health tool for responding to infectious disease outbreaks, including pandemics. However, little is known about the individual characteristics associated with support for NPIs, or whether they are consistent across regions. This study draws on survey data from four regions—Hong Kong, Singapore, Taiwan, and the United States—collected following the Severe Acute Respiratory Syndrome (SARS) outbreak of 2002–03, and employs regression techniques to estimate predictors of NPI support. It finds that characteristics associated with NPI support vary widely by region, possibly because of cultural variation and prior experience, and that minority groups tend to be less supportive of NPIs when arrest is the consequence of noncompliance. Prior experience of face-mask usage also results in increased support for future usage, as well as other NPIs. Policymakers should be attentive to local preferences and to the application of compulsory interventions. It is speculated here that some public health interventions may serve as ‘gateway’ exposures to future public health interventions.

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“…The exposed individuals are not able to transmit a disease to other susceptible individuals, whereas the infectious individuals are able to do. We assume that the mobility of infectious individuals can be lower than that of the other classes of individuals due to severe symptoms and/or travel restrictions [40–42]. Under the individual’s mobility depending on its internal state, we first perform individual-based simulations of the SEIR model in a square lattice and clarify the interplay between the latent period and the mobility for the final epidemic size.…”

Section: Introductionmentioning

confidence: 99%

Parameter Scaling for Epidemic Size in a Spatial Epidemic Model with Mobile Individuals

et al. 2016

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In recent years, serious infectious diseases tend to transcend national borders and widely spread in a global scale. The incidence and prevalence of epidemics are highly influenced not only by pathogen-dependent disease characteristics such as the force of infection, the latent period, and the infectious period, but also by human mobility and contact patterns. However, the effect of heterogeneous mobility of individuals on epidemic outcomes is not fully understood. Here, we aim to elucidate how spatial mobility of individuals contributes to the final epidemic size in a spatial susceptible-exposed-infectious-recovered (SEIR) model with mobile individuals in a square lattice. After illustrating the interplay between the mobility parameters and the other parameters on the spatial epidemic spreading, we propose an index as a function of system parameters, which largely governs the final epidemic size. The main contribution of this study is to show that the proposed index is useful for estimating how parameter scaling affects the final epidemic size. To demonstrate the effectiveness of the proposed index, we show that there is a positive correlation between the proposed index computed with the real data of human airline travels and the actual number of positive incident cases of influenza B in the entire world, implying that the growing incidence of influenza B is attributed to increased human mobility.

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Nonpharmaceutical Interventions for Pandemic Influenza, International Measures

Abstract: Closing international borders was usually ineffective in past pandemics and would be less effective today.

Cited by 268 publications

References 33 publications

Impact of Intensive Handwashing Promotion on Secondary Household Influenza-Like Illness in Rural Bangladesh: Findings from a Randomized Controlled Trial

Impact of Intensive Handwashing Promotion on Secondary Household Influenza-Like Illness in Rural Bangladesh: Findings from a Randomized Controlled Trial

Predicting support for non‐pharmaceutical interventions during infectious outbreaks: a four region analysis

Parameter Scaling for Epidemic Size in a Spatial Epidemic Model with Mobile Individuals

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